Dil jalta hai!

gerd.jpgDo you keep getting a burning, stabbing pain in your chest, especially after a meal? It’s probably not a cardiac problem but likely to be a more mundane ailment. It’s called gastro-esophageal reflux disease (GERD).

BURN, BABY, BURN

Your stomach, as you perhaps know, secretes strong acidic juices for digestion. Usually these juices remain in the stomach. If the valve at the top of your stomach (called the lower esophageal sphincter  or cardiac sphincter) doesn’t close properly, those acidic juices can gush upward. The result is a chemical burn. This is the most common cause of GERD.  It can also be caused by a portion of the upper stomach protruding above the diaphragm, called a hiatal hernia.

SYMPTOMS

GERD is painfully obvious. The characteristic symptom is a burning or stabbing pain under the chest bone, generally after a meal. It’s called ‘heartburn’ because it feels as if it’s coming from your heart. The pain can get quite alarming but in the absence of a genuine heart problem, it’s nothing to worry about.

TREATMENT

No problem. There are a variety of treatment options.

Most cases of GERD can be handled by simple antacid formulations. These can be taken either as a liquid suspension or in the form of an antacid tablet.

Please note : Chewable antacid tablets (like Digene) are strictly meant to be chewed only. Never swallow an antacid tablet whole. You may damage your stomach lining.

‘Raft’ antacids or foaming antacids contain alginates which form a floating gel raft over the stomach contents. Such antacids put a damper on heaving gastric juices.

For tough cases, there are several acid-reducers available on prescription. Proton-pump inhibitors like omeprazole, antacids like ranitidine and cimetidine and other drugs like cisapride and domperidone are particularly useful. At least one of them will tame a stubborn case of GERD.

Rarely, if the GERD is really nasty, corrective surgery can take care of that disobedient stomach valve.

SOME TIPS

If you have chronic ‘heartburn’ or chest discomfort, first get it checked out to rule out any cardiac problem.

Eat slowly and chew your food well. The spiciness of the food doesn’t really matter.

Remain upright for at least an hour after a meal. Don’t just crash out after your ‘bhojan’.

If the heartburn persists, please see your doctor. Although GERD is not exactly fatal, it can cause scarring of the esophagus. Over many years, it may even lead to ulceration and esophageal cancer.

No need to set your heart on fire for no reason.

Cheers … Srini.

For more information:

http://www.webmd.com/heartburn-gerd/default.htm

Eight glasses a day? You might DIE, you fool!

Of all the foolish medical myths out there, the most dangerous is the one that claims we must drink eight glasses of water a day for good health.

The average glass of water is 200 to 300 ml. You have been led to believe that you must drink between 1.6 to 2.4 liters of water a day.

Are you mad? That much water can actually kill you. There is an enormous amount of medical research that has clearly and repeatedly shown that too much water can indeed kill you.

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Why do you drink water?

Obviously, because your body needs it. Your body has to maintain a balance between its salts and water. The technical term is “osmomolarity”.

And how do you know when you should drink water?

Obviously, your body will tell you. To be more accurate, your brain will tell you. The sub-fornical organ is a specialised part of your brain that tells you when you need a drink of water. Your brain has a sophisticated and accurate mechanism for maintaining osmomolarity. You know it as Thirst.

And how do you know how much water is enough?

Once again, your brain will tell you. Just as the brain has a thirst mechanism, it also has an accurate inhibitory mechanism that tells you when enough is enough.

It’s called the swallowing inhibition response.

Simply put, you will find it difficult to swallow water after a certain point. At this point, stop drinking more water. Just stop.

Who came up with this eight-glasses-a-day crap anyway?

Well, there was a report published back in 1945 by the US Food and Nutrition Board that recommended a total water intake of 2.45 liters. Mind you, total water intake. That includes water from food, vegetables, fruits and beverages like coffee and tea. An apple for example, contains 86% water. A banana has 75% water. A cup of cooked rice about 65%. Rasam, sambar, most curries are 70% water. A cup of tea is 95% water. Even dry roasted peanuts contain 5% water.

Some manufacturer of bottled water misquoted this report, and started this ridiculous and dangerous myth about eight glasses a day.

There’s a more recent report by the US Food and Nutrition, published in 2005, that will give you every single detail you need to know about water intake, and more important, the real risks of drinking too much water.

You can download the entire report using the link I’ve given below.

What this means is that a normal adult who eats thrice a day and has two or more cups of tea or coffee, does not need more than three glasses of water a day.

Look at your urine. If it’s straw colored, you’re doing fine. If it’s dark yellow, drink a glass of water. If your urine is colorless, you’re in trouble. Don’t drink more water.

The health benefits of drinking eight glasses of water are: Zero.

Effect on skin: Nil
Effect on “toxins”: Nil
Effect on weight-loss: Nil.

On the other hand, the dangers of eight glasses of water:

Damage to kidneys: YES.
Increase in blood pressure: YES
Excessive strain on your heart: YES

By drinking eight glasses of water a day, you will lose too much sodium from your body. It’s called hyponatremia. And it is potentially fatal.

How about dehydration then?

Yes, dehydration can occur with severe diarrhoea, excessive sweating caused by heat, and some disease conditions. Elderly people sometimes forget to drink enough water. Only in such cases, and under medical advice, is higher water intake recommended.

So, I don’t need eight glasses a day?

For a normal adult, there is no medical justification for eight glasses of water a day. The health benefits are ZERO. The risks are very real.

Get this into your head: Too much water kills.

There are too many blogs and websites that rant about the “benefits” of overdrinking water. Please do not take medical advice from an unqualified, non-medical nitwit just because he/she has a stylish blog.

Educate yourself by talking to a doctor and by reading correct information from authentic sources. I’ve given some links at the bottom, to start you off. Do use them.

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

 

Useful links:

https://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx

http://www.med.umich.edu/1libr/Gyn/ObgynClinic/8GlassesWaterMyth.pdf

http://www.sciencealert.com/there-s-no-evidence-we-need-to-drink-eight-glasses-of-water-a-day-researcher-advises

Testing times.

Medical_Laboratory_Scientist_US_NIH

At some point in your life, you’ll be tested – by a clinical laboratory.

Medical tests provide information that your doctor may need to find out what’s wrong with you.

The sad fact is many clinical labs in India have poor quality standards. Until things change on the clinical scene, you have to ask your doctor:

SOME TEST QUESTIONS

Why?  Is the test usually done for your age group or will it diagnose a specific illness you may have?

What if?  If the result is abnormal, do you really have the illness? If the test result is normal, are you still safe?

When?  What’s the best time of the day to do the test?  Do you need to be on an empty stomach or avoid certain foods that may affect the test results?

Where?  The most important question and sometimes, the difference between life and death.  If your doctor seems to promote one particular testing lab., you need to know why.

Don’t hesitate to ask around about different labs. And don’t get deceived by corporate cleavages.  That dazzling receptionist won’t be doing the test – the chemist inside the lab will. In general, look for a testing lab that has the NABL certification.

And after? Will your existing treatment change in any way after the test?

Then what?  Suppose you don’t take the test at all, then what?  Will you suddenly drop down dead?

Most doctors honestly tell their patients if a given test isn’t really necessary or if they’re ordering the test merely to reassure the patient.  And if your doctor refuses to order a test in spite of your insisting on it, please listen to him.

BEAR IN MIND

Tests can be wrong.  They may produce a normal result even when illness is present  (a false-negative) or they may produce an abnormal result even in good health (a false-positive).

Many routine tests have not been subjected to rigorous research regarding their usefulness.  Cardiac stress tests for example, occasionally produce normal results even in patients with significant heart disease.

Ask about the risks associated with the test procedure itself.  An MRI scan is non-invasive and safe, but some patients can get really scared inside the coffin-like MRI tunnel.  I’ve seen several patients who had to be sedated before an MRI. When it was my turn for an MRI, I was a bit nervous too.

Whereas, a coronary angiogram or a colonoscopy is a clearly invasive test and carries a definite element of risk.  So don’t feel shy to ask, it’s your right.

Clinical tests are expensive, uncomfortable and sometimes cause unnecessary worry.  So be clear about why you need that clinical test.

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

Hawa ke saath saath!

farters.jpgDo you give out your best under “pressure”?  Do you frequently explode into action?  Do you blow your own trumpet, loudly and regularly?  You have the one problem that no one wants to have  – Flatulence.

What is Flatulence?

Flatulence is just air trying to escape from your digestive tract – from the wrong end.   Bacteria in your intestines form gases from the food you eat, and these gases have their own distinctive stench, unfortunately,

Excessive gas may signal a problem with your intestines. If it is serious enough, it can warrant a visit to the doctor.  Flatulence can also generate alarming but harmless symptoms like chest pain and breathlessness.

What causes flatulence?

Medicines: There are innumerable medications that can cause flatulence, some of these being antibiotics, pain killers, antidepressants and anthelmintics (worm killers).

Infection: Gastro-intestinal ailments like worms, ulcers, colitis, gastroenteritis, and irritable bowels can cause flatulence.  A liver disorder can also cause acute flatulence.

The Big Culprit: however, is your diet. Not just what you eat, but how you eat.

Relieving the pressure:

There are some things you could do to prevent embarrassment (and pollution):

Diet Control:  In particular, watch your intake of,

  • Lentils and Beans
  • Papaya and bananas
  • Milk and milk products
  • Baked goods and fluffy, whipped stuff
  • Any food that contains baking soda
  • Carbonated drinks and beer.

Eat slowly.   Mom was right.  Chew your food nice and slow.  If you eat too fast, you will invariably gulp in lots of air, which will make a noisy exit later.

Herbal remedies  Ginger, Hing (asafetida), fennel (saunf) and caraway (ajwain) are useful in controlling flatulence. This is one reason why it’s a tradition to chew saunf after a meal.

OTC (over the counter) formulations.  There are many branded formulations in the market but the most effective ones will contain Simethicone  (or dimethicone) which makes it easier to pass out the gas and Activated Charcoal, which adsorbs excess gas and removes it from the system.

“Bottomline”.

By itself, flatulence is harmless, although those around you may not agree.

If however, you have had chronic flatulence for more than four weeks, one suggests a visit to the doctor.  It may just be that you have a GI disorder.

Besides, don’t you want to do your bit for the environment ?

Heh, heh.

Srini.

A dose of Dosa.

sks-174245.JPGIt’s a multi-billion dollar industry in India, not to mention the rest of the world. It is breakfast, lunch, dinner, evening snack, fast food and health food, all in one. The dosa is, well, the dosa.

The idli isn’t really Indian in origin, but the dosa is totally desi. Dosa making goes all the way back to 600 AD, somewhere in south India.

The masala dosa on the other hand, was invented in the 1960’s, at Woodlands Hotel, Udupi, by one Kadandale Krishna Bhat. Potato curry was usually served separately with plain dosas. During a potato crisis in the 1960’s, Krishna Bhat served dosas with a layer of pureed potato curry applied inside the dosa, to save on potatoes. Thus was born the masala dosa.

In its classical form, the dosa is made with parboiled rice and urad dal, ground together in a ratio of 3:1, fermented overnight. As with the idli, the process of fermentation increases the dosa’s nutritive value, making it a super-food. There are several dosa versions without rice, like the ragi dosa, adai, pessaratu (made from moong dal), wheat dosa, cabbage dosa, and what not.

The traditional dosa is a powerhouse of nutrition. The normal dosa has about 80 calories only. It has significant amounts of vitamin B, carbohydrates, protein and almost no fat (provided it is not fried in ghee). Instant dosa mixes are simply not as good. And hotel dosas are generally not safe. Instead, make them at home, with parboiled rice and urad dal. Add some home-made potato curry, or better yet, add a lightly spiced paneer or soya curry, and you have one terrific low-cal, high-protein meal.longest dosa.jpg

There are almost as many dosa variants as there are cooks in India. Onion dosa, banana uttappa, pineapple uttappam, set dosa, benne dosa, neer dosa, and some weird ones like Amitabh dosa (six feet long. I’ve eaten one such), Punjabi dosa, and Schezuan dosa and chop suey dosa (of all the things!). They’re all great, of course.

My personal favorite: Kheema dosa – traditional dosa stuffed with chicken kheema. Superb stuff. (My mom would be scandalised!).

Cheers … Srini.

The Great Weight-loss hoax – part 2

obesity-crop-187102.JPGUnderstand this:

Obesity is a medical condition. Like all other medical conditions, obesity needs medical attention. Period.

So, first and foremost, you must consult your primary healthcare provider.

Disregard all promotional hype about supplements or herbals. Remember, this stuff is not made by people who deeply care about your weight or your health. These are people who want your money.

That does not necessarily mean that all nutra-peddlers are dishonest. But it also means that they are not necessarily scrupulously honest.

You have a medical condition. You talk to a medical professional.

So what are my options?

If you’re a few kilos overweight, and below a BMI of 26 or so, then a sensible doctor would advise proper diet and exercise – and nothing more.

Dieting means eating smart, making the correct choices, and still eating well. Exercise does not mean huffing and puffing in a stinking, expensive gym. It means getting off your butt, getting into moderate aerobic and anaerobic workouts, and also workouts that improve your flexibility and balance, like hathayoga.

The first-line treatment for weight management has always been, and will always be, diet and exercise.obesity-crop-1920.JPG

Across the world, every single government agency that regulates public healthcare solidly endorses this line of treatment. Diet and exercise.

What if I’m really obese?

If you’re above BMI 27 and you have a family history of diabetes or coronary disease, you are morbidly obese. Don’t worry. Your doctor has several options:

1) Prescription meds: These are medicines approved by the USFDA or the relevant government agency in your country, and available only on prescription.

Do they work? Yes, they do, within reasonable limits. And when taken under medical supervision.

Are they safe? There is no “safe” drug.

There is no “safe” dietary supplement or nutraceutical either.

In a medical context, “safe” means that the drug has been approved after rigorous testing over several years, and the benefits of the drug outweigh its potential side-effects.

Even so, any responsible doctor will think twice before prescribing a drug for weight-loss.

Six prescription drugs are in common use for obesity management. I won’t mention any names, in case you think I’m promoting any particular medicine. Each of them is useful in treating severe obesity and each has its own benefit-to-risk profile.

How long do I take prescription meds?

This is the difference between scientific obesity management and nutra-quackery.

Prescription meds are taken under medical supervision for limited periods of time. Depending on your response to the drug, your doctor may prescribe it for a few weeks to a few months. The doctor’s objective is to use drugs to bring down your weight to the point where you can take up a diet and exercise program. At this point, the drug will be discontinued.

The nutra-peddler on the other hand, will try to convince you that you should buy his “safe” nutraceutical stuff for the rest of your life. It’s “just” a dietary supplement, you will be told.  You can take his “safe” dietary supplement for the rest of your life and remain slim and sexy for the rest of your life.

Yeah, sure.

If you’re expected to consume a nutraceutical, every single day, for the rest of your life, don’t you think you should be deeply worried about its long-term effects on your body? And don’t you think your nutra-peddler should give you safety data on his weight-loss supplement? By long-term, one means over a period of ten years at least.

In most cases, your nutra-peddler won’t give you this data. Because he doesn’t have it. Because long-term safety studies cost money. Because it’s cheaper to hire a smart lawyer instead.

2) Surgery

For patients whose obesity is potentially life-threatening, and cannot be managed even with prescription drugs, a doctor will consider bariatric surgery. The objective of bariatric surgery is to temporarily or permanently reduce the size of your stomach, and thereby restrict the amount of food you can eat.

Bariatric surgery can result in significant and sustained weight-loss. But remember that any surgical procedure, even a simple tooth cavity filling, has an element of risk. And also remember that bariatric surgery is not a cosmetic procedure, like a liposuction or a facelift. Bariatric surgery is a serious intervention and it does carry some risk. When it is performed by the right surgeon, the procedure can be life-changing.

Any kind of surgical intervention is used as a last resort, and bariatric surgery is no exception.

But then, most obesity patients can be readily treated with diet and exercise, and if really necessary, a short course of prescription drugs.

Obesity can be psychologically devastating. I’ve seen how bad it can get.

In my opinion, nutra-peddlers who exploit your fear to sell you worthless and very expensive nutra-crap, are the lowest forms of human life on this planet.

I have spoken.

Srini.

 

Key references:

The NHLBI’s Obesity Education Intitiative, under the US government’s Dept of Health and Human services provides a wealth of information and booklets that you can download. I would seriously recommend that you read them.

Here’s the link:

https://www.nhlbi.nih.gov/health/resources/heart#obesity

Some juicy facts.

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Public domain image

So you thought fruit juices are good for your kids, eh?  So you thought all those “fortified” juices in fancy tetrapaks would make your child bounce and glow, eh?  So you thought a hefty swig of fruit juice four times a day would make you healthy, wealthy and wise, eh?

You’re wrong.

Way back in 2001, The American Association of Pediatrics (AAP) had issued a policy statement on the use of fruit juices [The use and misuse of fruit juice in pediatrics. Pediatrics, Volume 107, pages 1210-1213, 2001.] Here’s an extract:

Fruit juice offers no nutritional benefit for infants younger than 6 months and therefore should not be introduced into their diet.  For older infants and children, fruit juice offers no nutritional benefits over whole fruit.  Fruit drinks are not nutritionally equivalent to fruit juice. Juice is not appropriate for treating dehydration or managing diarrhea. 

Surprised?  You ought to be.  Here are some more juicy facts for you:

Excessive juice consumption may be associated with malnutrition and can cause diarrhea, flatulence, abdominal distention and tooth decay.

Unpasteurized juice may contain pathogens that can cause serious illnesses.  In place of ‘unpasteurized’ read ‘squeezed in a fruit juicer at home’.

Infants should not be given juice from bottles or hi-tech transportable covered cups that allow them to consume juice easily throughout the day. Infants should not be given juice at bedtime. Intake of fruit juice should be limited to one small glass per day for children 1 to 6 years old.  For children 7 to 18 years old, juice intake should be limited to two servings per day.

Children should be encouraged to eat whole fruits to meet their recommended daily fruit intake. Infants, children, and adolescents should not consume unpasteurized juice.

You can download the entire report here.

I could quote several other reports and articles about the perils of juicing, but I’m sure you can do your own research, instead of taking me at my word.

No point in squeezing the life out of all those fruits and raw vegetables. You may actually be doing yourself and your child some harm.

In case you didn’t get it, the message is …

JUICING IS UNSAFE!

Diet gurus would have us believe that juicing is the answer to mankind’s ills.  There are all kinds of ‘organic’ juice concoctions that promise to reverse disease, stop aging and generally bring happiness to one and all.  “Live”, uncooked juices, we are told, flush the body of “toxins”, leaving us in state of eternal bliss.

Bullshit.

When you juice the crap out of a fruit or vegetable, you lose all the other benefits you can get from it, like fiber for instance.

Fruit or vegetable juice is not a substitute for food. Fruits and vegetables are meant to be eaten.  What do you think your teeth are for?

Yes, fruits and vegetables are good for you. That’s the primary message of my blog.

But…eat your fruits and vegetables. Don’t drink them!

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.